CDC Officially Endorses Use Of PrEP Drug, Truvada, For HIV Prevention

​Could this move by the Center for Disease Control and Prevention (CDC) be a game changer in HIV prevention?

On Wednesday, the CDC has officially endorsed the use of Truvada, an antiretroviral drug that when taken as a daily pill can serve as pre-exposure prophylaxis (PrEP). Truvada has been proven to prevent HIV in 99% of individuals when used properly.

If broadly followed, the advice could transform AIDS prevention in the United States — from reliance on condoms, which are effective but unpopular with many men, to a regimen that relies on an antiretroviral drug.

It would mean a 50-fold increase in the number of prescriptions for the drug, Truvada — to 500,000 a year from fewer than 10,000. The drug costs $13,000 a year, and most insurers already cover it.

The guidelines tell doctors to consider the drug regimen, called PrEP, for pre-exposure prophylaxis, for gay men who have sex without condoms; heterosexuals with high-risk partners such as drug injectors or male bisexuals who have unprotected sex; patients who regularly have sex with anyone they know is infected; and anyone who shares needles or injects drugs.

The CDC is officially encouraging the use of PrEP in conjunction with condoms as Truvada does not prevent infection from other sexually transmitted infections such as gonorrhea and syphilis.

The CDC acknowledges that some gay men will choose to use PrEP in lieu of condoms, citing the 20 percent rise in unprotected sex amongst gay men between 2005 and 2011, according to a November CDC survey.

Still, the CDC maintains that the potential benefits of HIV prevention outweigh the costs of an increase in curable STDs.

“Making the perfect the enemy of the good is something we’ve got to get over,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and the country’s best-known AIDS doctor. “I strongly support the C.D.C. doing this.”

The new guidelines issued by the CDC still have their critics:

Michael Weinstein, president of the AIDS Healthcare Foundation, has called Truvada a “party drug” and argued that the drug regimen would encourage men to avoid condoms and thus increase the infection rate. He called the release of the guidelines “a shameful chapter in the history of the C.D.C.”

Ultimately, individuals will have to make their own decisions regarding how they choose to protect their sexual health. Undoubtedly this endorsement of PrEP by the CDC will have a major impact.

Dr. Jonathan Mermin, director of the C.D.C.’s national center for AIDS and other sexually transmitted diseases, said the new guidelines should save many lives.

“On average, it takes a decade for a scientific breakthrough to be adopted,” he said. “We hope we can shorten that time frame and increase people’s survival.”

While Truvada is expensive, private insurers and state Medicaid programs have generally covered such prescriptions, and Gilead--the producer of Truvada-- has a program that covers co-pays and gives Truvada to the uninsured. PrEP may be in reach for those that want it.

What are your thoughts on the new developments, Instincters? Will the CDC's endorsement of PrEP encourage you to take on the drug regimen? Will it impact your condom usage?

This is reckless. They are not saying that you will be HIV proof they are saying that you will be less likely to contract HIV. You see the difference? I think what they are trying to do is kill us off, but not knowing that once one goes then ten ore come in its place. I expect the HIV virus to get out of control because some silly boy will be taking the Truvada as he thinks that it will prevent him from catching the Virus but the sad truth is that it's not an inoculation against the virus but it makes it less likely that you catch the virus not totally protect you from, meaning there is still room for the virus to sneak right on in on you...VERY RECKLESS CDC VERY RECKLESS

Truvada has been shown to be "99% effective." Basically, that means they've had 100% success, but their sample size is too small to rule out a fluke chance that someone still might get it. The CDC also recommends using condoms, which are also "99% effective" at preventing the spread of STD's. Even assuming that both of these 99% effectiveness estimates are perfectly accurate - rather than conservative estimates, which is what they really are - the two together mean that you have about a 0.01% chance of getting HIV when used as recommended by the CDC. You have a better chance of getting in a car accident every 30 miles you're on the road. Additionally, HIV is no longer a death sentence, thanks to treatments such as... wait for it... Truvada, which has been shown to essentially halt all progress and stop the effects of the disease. So I would not call it, "very reckless", or even close to it.

If this drug was around 20 years ago, we would not even be having this discussion. There would have been celebrations and dancing in the street. I can only think about the people I've lost in my life and how many would still be around. Let's not wait for another infected generation. I thank that any tool in the arsenal against HIV is welcomed. Human nature, it has been shown, is difficult if not impossible to change. We are having sex.